Pre-Race Medical Screening and Educational Intervention Reduces Medical Complications

Abstract

We previously reported a high rate of medical complications (1/121 race starters) in a cohort of 65 865 runners participating in 21.1km and 56km races over a 4-year period (2008-2011) (SAFER study 1). PURPOSE: To determine if an online pre-race medical screening and educational intervention program reduces medical complications in distance running events. METHODS: An online pre-race medical screening (based on the European guidelines for pre-screening of leisure athletes participating in moderate- to high-intensity sports) and an educational intervention program was designed and introduced as part of the race registration process, in the period 2012 to 2015 at the Two Oceans Marathon races (21.1km and 56km). The incidence of medical complications (per 1000 race starters; all and serious life-threatening) during the 4-year post-intervention period (2012-2015: 87 343 race starters) was compared with the pre-intervention period (2008-2011: 65 865 race starters). RESULTS: Compared to the pre-intervention (baseline) period, there was a significant reduction in the incidence (per 1000 starters, 95% CI; adjusted for age group, gender and race distance) of all medical complications in all runners by 29% [pre=8.6 (7.9-9.4); post=6.1 (5.6-6.7), p<0.0001], 21.1km runners by19% [pre=5.1 (4.4-5.9); post=4.1 (3.6-4.8), p=0.0356], and 56km runners by 39% [pre=14.6 (13.1-16.3); post=9.0 (7.9-10.1), p<0.0001]. Serious life-threatening complications were significantly reduced in all runners by 64% [pre=0.6 (0.5-0.9); post=0.2 (0.1-0.4), p=0.0003; adjusted for age group and gender]. CONCLUSION: A pre-race medical screening and educational intervention program significantly reduced medical complications and serious life-threatening complications among all runners in community-based mass participation distance running events. The reduction in all medical complications was significant in both the 21.1km and 56km races. Pre-race screening and educational intervention programs could be introduced to reduce medical complications during endurance running events.